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Study of active neighborhoods in Detroit (StAND): study protocol for a natural experiment evaluating the health benefits of ecological restoration of parks.

ABSTRACT: BACKGROUND:Individuals living in deprived inner cities have disproportionately high rates of cancers, Type 2 diabetes and obesity, which have stress- and physical inactivity-related etiologies. This study aims to quantify effects of ecological park restoration on physical activity, stress and cardio-metabolic health outcomes. METHODS:The Study of Active Neighborhoods in Detroit is a quasi-experimental, longitudinal panel natural experiment with two conditions (restored park intervention (INT) and control (CNT)) and annual measurements at baseline and 3-years post-restoration. Individuals (sampled within 500?m of an INT/CNT park) serve as the unit of analysis. Restoration (n?=?4 parks) involves replacing non-native plants and turf with native plants; creating trails; posting signage; and leading community stewardship events. The CNT condition (n?=?5) is an unmaintained park, matched to INT based on specified neighborhood conditions. Recruitment involves several avenues, with a retention goal of 450 participants. Park measures include plant/avian diversity; usage of the park (SOPARC); signs of care; auditory environment recordings; and visual greenness using 360 imagery. Health outcomes include device-based physical activity behavior (primary outcome); salivary cortisol (secondary outcome); and several downstream health outcomes. Exposure to the INT will be assessed through visual contact time and time spent in the park using GPS data. Changes in health outcomes between years and INT versus CNT will be tested using generalized linear (mixed) models. DISCUSSION:Our study will examine whether restored urban greenspaces increase physical activity and lower stress, with public health planning implications, where small changes in neighborhood greenspaces may have large health benefits in low-income neighborhoods. STUDY REGISTRATION:Registration: OSF Preregistration registered March 31, 2020. Accessible from https://osf.io/surx7.

SUBMITTER: Pearson AL

PROVIDER: S-EPMC7204306 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Study of active neighborhoods in Detroit (StAND): study protocol for a natural experiment evaluating the health benefits of ecological restoration of parks.

Pearson Amber L AL Pfeiffer Karin A KA Gardiner Joseph J Horton Teresa T Buxton Rachel T RT Hunter Ruth F RF Breeze Victoria V McDade Thomas T

BMC public health 20200507 1

<h4>Background</h4>Individuals living in deprived inner cities have disproportionately high rates of cancers, Type 2 diabetes and obesity, which have stress- and physical inactivity-related etiologies. This study aims to quantify effects of ecological park restoration on physical activity, stress and cardio-metabolic health outcomes.<h4>Methods</h4>The Study of Active Neighborhoods in Detroit is a quasi-experimental, longitudinal panel natural experiment with two conditions (restored park interv ...[more]

PMID: 32380967

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Project description:BackgroundThe question of whether neighborhood environment contributes directly to the development of obesity and diabetes remains unresolved. The study reported on here uses data from a social experiment to assess the association of randomly assigned variation in neighborhood conditions with obesity and diabetes.MethodsFrom 1994 through 1998, the Department of Housing and Urban Development (HUD) randomly assigned 4498 women with children living in public housing in high-poverty urban census tracts (in which ≥40% of residents had incomes below the federal poverty threshold) to one of three groups: 1788 were assigned to receive housing vouchers, which were redeemable only if they moved to a low-poverty census tract (where <10% of residents were poor), and counseling on moving; 1312 were assigned to receive unrestricted, traditional vouchers, with no special counseling on moving; and 1398 were assigned to a control group that was offered neither of these opportunities. From 2008 through 2010, as part of a long-term follow-up survey, we measured data indicating health outcomes, including height, weight, and level of glycated hemoglobin (HbA(1c)).ResultsAs part of our long-term survey, we obtained data on body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) for 84.2% of participants and data on glycated hemoglobin level for 71.3% of participants. Response rates were similar across randomized groups. The prevalences of a BMI of 35 or more, a BMI of 40 or more, and a glycated hemoglobin level of 6.5% or more were lower in the group receiving the low-poverty vouchers than in the control group, with an absolute difference of 4.61 percentage points (95% confidence interval [CI], -8.54 to -0.69), 3.38 percentage points (95% CI, -6.39 to -0.36), and 4.31 percentage points (95% CI, -7.82 to -0.80), respectively. The differences between the group receiving traditional vouchers and the control group were not significant.ConclusionsThe opportunity to move from a neighborhood with a high level of poverty to one with a lower level of poverty was associated with modest but potentially important reductions in the prevalence of extreme obesity and diabetes. The mechanisms underlying these associations remain unclear but warrant further investigation, given their potential to guide the design of community-level interventions intended to improve health. (Funded by HUD and others.).

Project description:This study integrates insights from social network analysis, activity space perspectives, and theories of urban and spatial processes to present an novel approach to neighborhood effects on health-risk behavior among youth. We suggest spatial patterns of neighborhood residents' non-home routines may be conceptualized as ecological, or "eco"-networks, which are two-mode networks that indirectly link residents through socio-spatial overlap in routine activities. We further argue structural configurations of eco-networks are consequential for youth's behavioral health. In this study we focus on a key structural feature of eco-networks--the neighborhood-level extent to which household dyads share two or more activity locations, or eco-network reinforcement--and its association with two dimensions of health-risk behavior, substance use and delinquency/sexual activity. Using geographic data on non-home routine activity locations among respondents from the Los Angeles Family and Neighborhood Survey (L.A.FANS), we constructed neighborhood-specific eco-networks by connecting sampled households to "activity clusters," which are sets of spatially-proximate activity locations. We then measured eco-network reinforcement and examined its association with dimensions of adolescent health risk behavior employing a sample of 830 youth ages 12-17 nested in 65 census tracts. We also examined whether neighborhood-level social processes (collective efficacy and intergenerational closure) mediate the association between eco-network reinforcement and the outcomes considered. Results indicated eco-network reinforcement exhibits robust negative associations with both substance use and delinquency/sexual activity scales. Eco-network reinforcement effects were not explained by potential mediating variables. In addition to introducing a novel theoretical and empirical approach to neighborhood effects on youth, our findings highlight the importance of intersecting conventional routines for adolescent behavioral health.

Dataset Information

Study of active neighborhoods in Detroit (StAND): study protocol for a natural experiment evaluating the health benefits of ecological restoration of parks.

Publications

Study of active neighborhoods in Detroit (StAND): study protocol for a natural experiment evaluating the health benefits of ecological restoration of parks.

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